The present invention concerns a surgical retractor, and in particular to a device for creating an artificial cavity by distracting soft-tissue.
Surgical retractors for positioning tissue at a surgical site are known in the related art as an aid in performing surgical procedures. One such device is known from U.S. Pat. No. 6,033,362 to Cohn (xe2x80x9cCohnxe2x80x9d). This known surgical retractor is used for minimally invasive direct coronary bypass procedures to arrest movement of the grafting site while the heart continues pumping. The surgical retractor disclosed by Cohn has a single handle for detachably connecting the retractor to a manipulating instrument. The single handle, however, limits the ease and ability of the plate to be quickly and reliable positioned at surgical sites located in the torso, arms, or legs. Thus, there exists a need for an improved retraction device.
The present invention relates to a tissue retraction plate for displacement of soft tissue. The plate has upper and lower surfaces and a plurality of connecting elements. Each connecting element is configured and dimensioned to removably secure an elongate member. Coupling of the elongate members to the connecting elements allows lifting of the plate to retract soft tissue thereby creating a cavity to perform a surgical procedure.
In one embodiment, the plate has a disk shape. In another embodiment, the plate has a longitudinal axis and comprises first and second ends, a middle portion therebetween, and a window on the middle portion and extending from the upper surface through the lower surface. The window forms an opening for performing a surgical procedure. The connecting elements can be positioned on the first and second ends. In one embodiment, the window comprises about 60% to about 75% of the middle portion of the plate. In another embodiment, the window comprises about 35% to about 57% of the upper side of the plate. In yet another embodiment, a ratio of a first area defined by the first and second ends to a second area defined by the middle portion ranges from about 0.40 to about 0.60. The connecting elements can be arranged symmetrically about the longitudinal axis of the plate, and can be divided into a first set located on the first end of the plate, and a second set located on the second end of the plate. The first and second sets can be substantially identical.
A number of mechanisms can be used to couple the elongate members to the connecting elements. In one embodiment, each of the connecting elements comprises a bore each having a central axis, an inner diameter, and a threaded inner surface, with the central axis of the bore substantially perpendicular to the longitudinal axis of the plate. The bore can be cylindrical, or taper from the upper surface to the lower surface. In another embodiment, at least one of the connecting elements comprises a bore extending from the upper surface to the lower surface of the plate, and has a slot on the lower surface intersecting the bore and operatively configured to slidably receive a rod having a T-end.
The present invention also relates to a retraction device for retracting soft tissue. The device includes the above-described retraction plate and at least two rods. Each rod has an end configured and dimensioned to be detachably secured to one of the connecting elements. Coupling of the rods to the connecting elements allows lifting of the plate to retract soft tissue, thereby creating a cavity to perform a surgical procedure. As previously noted, the plate can have a longitudinal axis and includes first and second ends and a window located there between and extending from the upper surface through the lower surface. The window forms an opening for performing the surgical procedure. Connecting elements can be located on the first and second ends. In one embodiment, each connecting element comprises a bore having an inner thread and the ends of each rod are threaded and configured to mate with the inner thread. In another embodiment, at least one of the connecting elements comprises a cylindrical bore extending from the upper surface to the lower surface of the plate. The lower surface of the plate has a slot intersecting the bore and operatively configured to slidably receive a rod having a T-end.
The present invention also relates to a method for retracting soft tissue. An incision is made, and fascia near the incision are separated to create an opening. The above described retraction plate is inserted through the incision and into the opening. Elongate members are then coupled to plate connecting elements. The coupled elongate members are then pulled to retract soft tissue, for accessing a surgical site through the plate window to perform a surgical procedure. Additionally, the plate may be bent, or a cavity may be created with an inflatable member to facilitate soft tissue retraction according to the method of the present invention.